Walter M, Thomas G
CHU de Brest, Hôpital de Bohars, 29820 Bohars.
Encephale. 2009 Dec;35 Suppl 7:S286-90. doi: 10.1016/S0013-7006(09)73488-8.
After first providing a theoretical framework including the contributions of social constructivist and biological approaches to the comprehension of mental diseases in general and depression in particular, the authors stress the small number of publications mentioning a direct link between sociocultural factors and the severity of depression. However, there are indirect arguments that are classified into two groups : modifications based on the cultures of clinical expression (somatisation, delirious ideas) on one hand and the weight of social and individual views of depression and of its consequences in terms of stigmatisation on the other. These transcultural variations modify the process of seeking care and, thus, the progression of the disease towards increased severity. The authors point out, in conclusion, that the initial proposition could be reversed as some have postulated that the central role occupied by the diagnosis of depression is a phenomenon of civilisation or even the symptom of the severity of the uneasiness of western society.
在首先提供了一个理论框架之后，该框架涵盖了社会建构主义和生物学方法对理解一般精神疾病尤其是抑郁症的贡献，作者强调提及社会文化因素与抑郁症严重程度之间直接联系的出版物数量很少。然而，存在一些间接论据，这些论据可分为两类：一方面是基于临床表达文化（躯体化、妄想观念）的变化，另一方面是社会和个人对抑郁症及其耻辱化后果的看法的影响。这些跨文化差异改变了寻求治疗的过程，从而改变了疾病向更严重程度发展的进程。作者最后指出，最初的观点可能会被颠倒，因为有些人假设抑郁症诊断所占据的核心地位是一种文明现象，甚至是西方社会不安加剧的严重程度的症状。
